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By Concettina (Tina) Tolomeo,(eds.)

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1998). Oxygen at high altitude. British Medical Journal, 317(7165), 1063–1066. , & Copland, I. (2002). Overview of lung development. ), 4–7. , & Planzer, R. (1996). , p. 618). Fort Worth: Saunders College Publishing/Harcourt Brace College Publishers. Sircar, S. (2008). Principles of medical physiology (pp. 309–310). New York: Thieme. , Treffers, P. , Koppe, J. , & Hoeks, J. (1990). Physical development and medical history of children who were treated antenatally with corticosteroids to prevent respiratory distress syndrome: A 10- to 12-year follow-up.

Normal respiratory rates based on age are as follows: Age Infants Toddlers Preschoolers School-age children Adolescents Rate (breaths/min) 30–40 24–26 24 20 20 (Custer & Rau, 2009) Next, inspect respiratory effort, respiratory pattern, and chest expansion. Breathing should be relaxed and regular, and chest expansion should be symmetrical. The inspiratory-to-expiratory ratio (I : E ratio) should be 1:2. , 2003). The chest should be inspected for the presence of retractions. The nurse should remember that newborns and infants have a chest wall that is more compliant than older children and adults.

The decreased severity and incidence of RDS lead to a decrease in the need for surfactant therapy, supplemental oxygen, and mechanical ventilation (National Institute of Child Health and Human Development, 1994). A similar clinical picture is seen in term infants who have inherited surfactant deficiencies secondary to mutations of the surfactant proteins SP-B and SP-C. This leads to intracellular accumulation of proteins and extracellular deficiency of surfactant proteins. These mutations are a cause of both familial and sporadic interstitial lung disease.

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